The brain is a particularly rare site of metastasis from papillary microcarcinoma, with only few cases described in the literature. We present a case of 59-year-old man who presented with seizures and dysphasia due to left frontal lobe cystic mass, which was excised and turned out on histopathology to be of thyroid origin. Total thyroidectomy was performed and histology showed multifocal papillary microcarcinoma with the largest focus of 3mm with no other adverse features. The patient had ablative radioactive iodine postoperatively, with subsequent exit scan showing no uptake in the brain. Follow-up brain magnetic resonance imaging showed continuous regression of the surgical cavity. Although rare, such cases should be aggressively treated and followed up over the long term, because of reported associated high mortality.
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http://dx.doi.org/10.1308/rcsann.2020.0041 | DOI Listing |
Gland Surg
December 2024
Department of Thyroid and Neck Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Background: Multifocality is a distinctive feature of papillary thyroid carcinoma (PTC); however, the biological behavior of PTC and its optimal management strategy remain unclear. The aim of this study was to analyze the clinical features and prognostic differences of multifocal papillary carcinoma and to guide the precise treatment of multifocal papillary carcinoma.
Methods: The medical records of 1,139 patients with PTC who had undergone total or hemi-thyroidectomy between April and October 2013 at the Tianjin Medical University Cancer Institute and Hospital were reviewed.
Am J Otolaryngol
December 2024
Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Technion, Haifa, Israel.
Objective: Given the good prognosis of low-risk papillary thyroid microcarcinomas (lrPTMCs), accurate risk stratification is valuable to optimize management: active surveillance (AS) vs. hemithyroidectomy (HT). BRAF positive lrPTMC is associated with increased recurrence risk; hence, AS was suggested for mutation-negative lrPTMC.
View Article and Find Full Text PDFGland Surg
November 2024
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Thyroid cancer is one of the most common endocrine tumors and preoperative diagnosis of thyroid follicular neoplasm (FN) is challenging. Commonly used examination methods have difficulty in distinguishing thyroid cancer from other follicular lesions. At the same time, with the recently released World Health Organization (WHO) guidelines, the risk classification of FNs of the thyroid is a new enlightenment for clinicians in the diagnosis and treatment.
View Article and Find Full Text PDFActive surveillance (AS) has been widely adopted as an alternative to immediate surgery owing to the indolent nature and favorable outcomes of papillary thyroid microcarcinoma (PTMC). AS is generally recommended for tumors measuring ≤1 cm without aggressive cytological subtypes, risk of gross extrathyroidal extension (ETE), lymph node metastasis (LNM), or distant metastasis. AS requires careful patient selection based on various patient and tumor characteristics, and ultrasound (US) findings.
View Article and Find Full Text PDFObjective: To evaluate the therapeutic effects of microwave ablation (MWA) versus surgery in treating low-risk papillary thyroid microcarcinoma (PTMC) and to assess recurrence-free survival (RFS) in patients with and without the BRAFV600E mutation.
Methods: Between August 2016 and September 2022, 158 patients diagnosed with low-risk PTMC treated with MWA and 288 patients who underwent surgical treatment were retrospectively analyzed. All patients were followed-up for over a year.
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